Urgent Advice Needed!

I am so sorry for your cat's illness. If you don't have them already, I strongly urge you to go to your vet's tomorrow and get copies of all of your cat's lab results. You'll need them in order to make sense of the information you research online, and we'll need to see them posted on this thread in order to provide you with the most useful and relevant suggestions and guidance.

The following explanation of high calcium came from this website:

Broadway Veterinary Hospital / Laboratory Assessment Descriptions

"The calcium level high. This is always concerning. A persistently high calcium level, or hypercalcemia, can be toxic to kidney cells and it leads to poor muscle function, especially within the intestines, heart and limbs. It can also lead to hypertension, urinary stones and tissue mineralization. A high calcium level can be due to kidney disease, certain cancers, over-supplementation, Vitamin D toxicity, a hormonal disease called hyperparathyroidism or it may be idiopathic, meaning it is occurring for unexplained reasons."

As you can see, cancer is only one of the potential causes of high calcium. There may have been other indicators in your cat's lab work that pointed toward a cancer diagnosis, but without seeing the test results, that would only be a guess. An ultrasound may provide more diagnostic information, but a biopsy would likely be the only definitive diagnostic option for cancer.

If I were you, I wouldn't deal with a vet who sent my cat home with nothing more than a prescription food that she almost certainly won't eat, and told you to come back in a week. Given your cat's current condition, it sounds to me like your vet is sending her home assuming that she'll die before she has to deal with her again. Personally, I'd find another vet immediately - one who actually cares about my cat's critical condition and is willing to take an immediate and proactive role in diagnosing and treating my cat.

There's certainly no value to your cat in allowing her to continue to suffer. Either take her to a vet who will treat her with the urgency, compassion, and competency she needs and deserves, or have her euthanized. She needs you to get her the help she needs, one way or the other.

I wish your cat the best possible outcome.

Laurie

Thank you for you time and advice Laurie.

We took Liza to another Vet this morning for a second opinion. She said what my other Vet had diagnosed - Cancer. With a high Calcium level of 13 (normal range is between 8-10) and her age against her then it's more than likely cancer of some kind. She did an exam and Liza is very sensitive in the abdomen. So she assumes there is a mass of some kind there. We could do an ultrasound to be sure and to find out how far the cancer has spread and do a biopsy. But to be honest i don't know if I want to put Liza through another procedure. They would have to put her under to do the ultrasound and I don't think she is strong enough for anymore tests. The vet mentioned she doesn't think she has much time left. The ultrasound will only confirm what we know. We really can't afford any surgery or chemo and I don't want to put her through that. Poor thing has been in and out of the Vets so many times during the past 2yrs.

My husband and i have decided to let her go, we are having someone come to the house on Friday.

NatalieLucy said:

Very true! Can I ask Laurie what procedures are you doing with your cat? Did you do an ultrasound was there a mass in the intestines? I keep going back on if I should just schedule her for an ultrasound. But I don't know what good it will do. Liza has been on Prednisolone for about a month now due to her sinus infection. The vet said for us to keep her on this and up the dose from half to one a day. She said this can shrink the tumor. Liza has been rejecting them the past week when I do manage to get it down her she does on occasion throw it back up. Obviously this won't cure the cancer but will buy her sometime, how much time though? I haven't been able to get her to eat much I do have to force feed her and she does on occasion throw that back up to.

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I've never typed all of this out before, but I think it's important to try to put Noddy's undiagnosed condition into the most informed possible context. Noddy is a massive cat who spent the majority of his adult life morbidly obese at 26+ lbs. Aside from the obesity itself and a mild limp in one front leg probably caused by that obesity, he was always the picture of good health. He was lazy, of course, but his appetite was strong, his stomach happily digested the high-carb kibble diet I was feeding at that time, and he never had a sickly day.

Then in 2007 at the age of 12, Noddy had a diabetes scare that made me finally get serious about taking all of that extra weight off of him (and my other cats). Over the next 18 mos, Nods gradually and deliberately lost about 10 lbs and achieved an optimal weight of 16.5 lbs.

Coincidentally or not, it was during the weight loss period after I transitioned him to a primarily raw diet that Noddy started developing GI problems. He ate the raw diet without problems for several months, then suddenly started vomiting every bit of raw meat/organs/bones I tried to feed him. I necessarily switched him to canned and kibble foods. From then on, Noddy would cycle through periods when he could tolerate one type of food (canned, kibble, or raw), but not another.

About six months ago, Noddy suddenly started vomiting everything he ate. He couldn't keep anything down. He dropped weight quickly. My vet prescribed metoclopramide to control the vomiting, which Noddy has been taking twice daily since the constant vomiting started. The vomiting stopped, for the most part, but Noddy still had very little appetite. The weight loss continued, and he clearly didn't feel well. I gave him 1/8 Zantac 75 daily to control stomach acid, and anywhere from 100-150 ml of Lactated Ringer's subQ daily to keep him hydrated. I occasionally also gave him 1/4 of a cyproheptadine to stimulate appetite, but it didn't work on him.

After Noddy had lost 3 lbs with no sign of stopping, I finally decided to risk Prednisolone. Because of Noddy's history of morbid obesity, pred carries a substantial risk of triggering diabetes in him, which is why I had been resisting putting him on it earlier. But between the risk of diabetes and the reality of starving himself to death, I opted for the diabetes risk. He took prednisolone at a dose of 5 mg twice daily for the last several months, during which time he gained back two of the three pounds he had lost.

Unfortunately, Noddy's appetite is still minimal, so I've been supplementing the small amount he eats on his own with syringe feedings for months now. His syringe slurry is made up of premium quality canned foods, cheap "tasty" canned foods, Nutristat, fish oil, potassium gluconate, methylcobalamin, folic acid, acidophilus, taurine, and Miralax.

Once Noddy's condition stabilized and he was no longer either improving or getting worse, my vet recommended I slowly start reducing his pred dose, which I did. Unfortunately, even the tiniest dose decrease caused him to backslide and start to act noticeably sicker. He started rejecting his syringe feedings and started vomiting occasionally, in spite of the metoclopramide. I returned his dose to 5 mg twice daily, but so far, his condition has not improved back to where it was before the dose decrease. It's only been a few days, though, so I'm still hopeful. I've started giving him 1/8 Zantac 75 once daily again, and that may be helping a bit to settle his stomach.

Throughout all of this, the only notable issue in his bloodwork has been renal values at the upper edge of the normal range, indicating that Noddy has been in early stage renal failure for more than a year. His renal values have been stable during that time with no obvious progression of the disease so far.

Noddy has experienced no abdominal tenderness at all, and my vet has been unable to palpate any obvious masses. My vet has speculated that Noddy may have pancreatitis, but pancreatitis typically causes substantial abdominal tenderness, so I don't believe that's at play. I suspect that Noddy has either intestinal lymphoma or IBD, both of which I would be managing the same way I'm managing him now, so further diagnostics seem unproductive. I have not had an ultrasound or any type of biopsy performed on Noddy.

My boy is worrying me since I tried reducing his pred dose. He's had several bad days in a row now, and it's stressing us both out. I hope that returning the pred to his original dose and adding Zantac 75 to his daily regimen will turn him around again.

I hope you can follow all of this and not get too confused by it. Please feel free to ask me any other questions you may have about Noddy's management or history. There are a number of similarities between Liza's condition and Noddy's, but there are also some key dissimilarities.

The only advice I would offer you now is to make whatever decision you're going to make about how to proceed with Liza very quickly so as to minimize any suffering. If you decide to pursue further diagnostics, do them as soon as possible. If you decide to euthanize, don't delay that, either.

I wish you and Liza the best possible outcome, whatever your decision.

Laurie

So sorry to hear about your kitty's illness. I just wanted to share our experience with you. Our kitty stopped eating and became lethargic right after her rabies vaccination. We had tests done and it was cancer. They wanted to do ultrasound and needle aspiration of the tumor. If those tests confirmed the type of cancer then they would recommend chemo.

Best case scenario was 4-6 months life expectancy. They do chemo in hazmat suits and we wouldn't be able to be by her side for the procedure. There was no way we were going to put our baby through that. Then we made one of the hardest decisions of our lives. Our choice was to euthanize her in our home with my wife grooming her and me scratching her ears. It was very peaceful. Miss her horribly. It was just 2 months ago.

She was just so robust and fearless and within 2 weeks she was obviously in pain and miserable. She passed on before she was skin and bones. She could still purr softly. She could still walk past us and ignore us like the queen of the house has a right to.

We can't make the decision for you, but I just wanted to share our experience with you. Two more things I would like to mention. We got some painkiller that you can squirt on their gums. That made her so much more comfortable. Buprenex. We also got her to drink some canned tuna juice.

Once again I am so sorry your kitty is so sick. Please keep us updated - I will be looking for posts from you. I encourage you to stick around the forums and read as well as post away. You will never find a nicer bunch of cat people to help you through this very tough time in your lives. Take care, Chuck.

Laurie - thank you for telling me Noddys story. Yes there are similarities but also dissimulatirs. Her bloodwork is all normal except from the high calcium. Her kidneys are fine. Noddy has been doing well on the steroids and now when you've reduced his dose he's getting worse. That's how I feel with Liza she's had 3 good days on the pred and she's doing a little better eating a little more on her own but I think this is down to the steroids.

This morning she wet on my bed I guess she didn't have the energy to use the litter box. We have the appointment still set for tomorrow afternoon to ethaunize her. We do however have another appointment in the morning for an x-ray to determine of there is a mass. We wanted to do an ultrasound but the cost is a little high. Do you think an x-ray is wise?

Chuck - thank you for sharing your story. Can I ask what results made your kitty have a definitive diagnosis of Cancer? Was her calcium high also? I'm trying to understand what other things in bloodwork they go off to determine its Cancer.

NatalieLucy said:

Noddy has been doing well on the steroids and now when you've reduced his dose he's getting worse.

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That does seem to be what's happening, yes, but I really have no way of definitively correlating his condition with the pred.

Do you think an x-ray is wise?

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It can't hurt, but it also may not identify soft tissue masses, from what I understand. Also, even if it does indicate abnormalities, I don't think it can differentiate between, say, a foreign body obstruction and a tumorous mass. In short, I don't believe an x-ray is going to give you any definitive information. I could be wrong about that, though. You should certainly discuss it with the vet to find out what information you may gain from an x-ray.

I'm trying to understand what other things in bloodwork they go off to determine its Cancer.

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This, too, is something you need to discuss with the vet. I think the euthanasia is going to be harder on you than necessary unless you gain some understanding of this situation. The way to do that is to make it clear to your vet that you need to understand exactly how the likely cancer diagnosis was reached. Don't stop asking questions until you are satisfied that the vet has told you everything the vet knows at this point.

Laurie

laurief said:

That does seem to be what's happening, yes, but I really have no way of definitively correlating his condition with the pred.

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That's how I feel with Liza. She's doing better on the Pred but it's not going to solve the root cause of the issue just suppress it. The Vet told me today if she's doing better on the Pred then not to Euthanize her as there is a chance she can pull through this as Pred can shrink tumors. But in my mind the cancer will eventually win, and I don't want to put her through all this.

laurief said:

In short, I don't believe an x-ray is going to give you any definitive information. I could be wrong about that, though. You should certainly discuss it with the vet to find out what information you may gain from an x-ray.

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Thanks we will do that, I guess we thought that if the x-ray could determine some sort of a mass we would know in short that it was cancer.

laurief said:

I think the euthanasia is going to be harder on you than necessary unless you gain some understanding of this situation. The way to do that is to make it clear to your vet that you need to understand exactly how the likely cancer diagnosis was reached.

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From what I understand cancer is the more than likely option due to her age and symptoms along with the bloodwork. I pretty much got that from the second vet but the only way to be sure was to do an ultrasound. Now I could wait till Monday for my regular vet to do it for $200 but I had a recommendation of the second opinion vet and they can do it tomorrow for $400. It's a lot of money that we don't have right now, I have drained my kitty account. I also don't want to wait till Monday, as I feel the longer I put it off the longer she can be in pain for.

This is such a hard decision to make, I do appreciate your time though.